| Thrombus aspiration in ST elevation myocardial infarction: comparative efficacy in patients treated early and late after onset of symptoms. | |
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MedLine Citation:
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PMID: 20659947 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Restoration of myocardial perfusion is the goal of percutaneous coronary intervention (PCI) in patients with ST elevation myocardial infarction. A major predictor of no-reflow is the increasing time to treatment (TTT). Thrombus aspiration (TA) is reported to improve myocardial reperfusion as compared with standard PCI (SP). OBJECTIVE: To investigate the influence of TTT on TA efficacy. DESIGN: Pooled analysis of individual patients' data of three prospective randomised trials comparing TA and SP. PATIENTS: A total of 299 patients (150 in TA group and 149 in SP group) entered the study. The study population was divided into three subgroups according to the TTT: < or = 3 h (short TTT subgroup), >3 h to < or = 6 h (intermediate TTT subgroup), >6 h to < or = 12 h (long TTT subgroup). MAIN OUTCOME MEASURES: The goal of the study was the comparison of optimal myocardial reperfusion, defined as the combination of myocardial blush grade 2 or 3 at post-PCI angiography and ST resolution more than 70% at post-PCI ECG, between SP and TA according to TTT. RESULTS: In the SP group, increasing TTT was associated with a decreased rate of optimal reperfusion (27.4% vs 17.9% vs 10%, p for trend=0.06), whereas in the TA group the same trend was not seen (40.9% vs 33.8% vs 50%, p for trend=0.93). In a multivariate logistic regression model, a significant interaction (p=0.04) between time to treatment and thrombus aspiration was observed. CONCLUSIONS: TA limits the adverse effects of TTT prolongation on myocardial reperfusion. |
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Authors:
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Maria De Vita; Francesco Burzotta; Italo Porto; Dariusz Dudek; Thierry Lefèvre; Carlo Trani; Waldemar Mielecki; Giampaolo Niccoli; Giuseppe G L Biondi-Zoccai; Filippo Crea |
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Publication Detail:
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Type: Comparative Study; Journal Article; Meta-Analysis |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: 96 ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-27 Completed Date: 2010-08-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: England |
Other Details:
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Languages: eng Pagination: 1287-90 Citation Subset: AIM; IM |
Affiliation:
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Cardiology Department, Morgagni-Pierantoni Hospital, Forlì, Italy. mariarosariadevita77@libero.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary / methods* Coronary Thrombosis / complications, therapy* Female Humans Male Middle Aged Myocardial Infarction / etiology, therapy* Myocardial Reperfusion / methods Randomized Controlled Trials as Topic Suction Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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